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Lean six sigma

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https://www.readbyqxmd.com/read/29144156/upmc-prescription-for-wellness-a-quality-improvement-case-study-for-supporting-patient-engagement-and-health-behavior-change
#1
Rebecca J Maners, Eric Bakow, Michael D Parkinson, Gary S Fischer, Geoffrey R Camp
Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system...
November 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29136390/assurance-of-myeloid-growth-factor-administration-in-an-infusion-center-pilot-quality-improvement-initiative
#2
Pamela Maree Ramirez, Barry Peterson, Christine Holtshopple, Kristina Borja, Vincent Torres, Lucille Valdivia-Peppers, Julio Harriague, Melanie D Joe
PURPOSE: Four incident reports involving missed doses of myeloid growth factors (MGFs) triggered the need for an outcome-driven initiative. From March 1, 2015, to February 29, 2016, at University of California Irvine Health Chao Infusion Center, 116 of 3,300 MGF doses were missed (3.52%), including pegfilgrastim, filgrastim, and sargramostim. We hypothesized that with the application of Lean Six Sigma methodology, we would achieve our primary objective of reducing the number of missed MGF doses to < 0...
November 14, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29098756/reducing-the-risk-of-healthcare-associated-infections-through-lean-six-sigma-the-case-of-the-medicine-areas-at-the-federico-ii-university-hospital-in-naples-italy
#3
Giovanni Improta, Mario Cesarelli, Paolo Montuori, Liberatina Carmela Santillo, Maria Triassi
RATIONALE, AIMS, AND OBJECTIVES: Lean Six Sigma (LSS) has been recognized as an effective management tool for improving healthcare performance. Here, LSS was adopted to reduce the risk of healthcare-associated infections (HAIs), a critical quality parameter in the healthcare sector. METHODS: Lean Six Sigma was applied to the areas of clinical medicine (including general medicine, pulmonology, oncology, nephrology, cardiology, neurology, gastroenterology, rheumatology, and diabetology), and data regarding HAIs were collected for 28,000 patients hospitalized between January 2011 and December 2016...
November 3, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29072887/axiomatic-design-of-a-framework-for-the-comprehensive-optimization-of-patient-flows-in-hospitals
#4
Gabriele Arcidiacono, Dominik T. Matt, Erwin Rauch
Lean Management and Six Sigma are nowadays applied not only to the manufacturing industry but also to service industry and public administration. The manifold variables affecting the Health Care system minimize the effect of a narrow Lean intervention. Therefore, this paper aims to discuss a comprehensive, system-based approach to achieve a factual holistic optimization of patient flows. This paper debates the efficacy of Lean principles applied to the optimization of patient flows and related activities, structures, and resources, developing a theoretical framework based on the principles of the Axiomatic Design...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29065578/axiomatic-design-of-a-framework-for-the-comprehensive-optimization-of-patient-flows-in-hospitals
#5
Gabriele Arcidiacono, Dominik T Matt, Erwin Rauch
Lean Management and Six Sigma are nowadays applied not only to the manufacturing industry but also to service industry and public administration. The manifold variables affecting the Health Care system minimize the effect of a narrow Lean intervention. Therefore, this paper aims to discuss a comprehensive, system-based approach to achieve a factual holistic optimization of patient flows. This paper debates the efficacy of Lean principles applied to the optimization of patient flows and related activities, structures, and resources, developing a theoretical framework based on the principles of the Axiomatic Design...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29025066/supply-and-demand-application-of-lean-six-sigma-methods-to-improve-drug-round-efficiency-and-release-nursing-time
#6
Maríosa Kieran, Mary Cleary, Aoife De Brún, Aileen Igoe
Objective: To improve efficiency, reduce interruptions and reduce the time taken to complete oral drug rounds. Design: Lean Six Sigma methods were applied to improve drug round efficiency using a pre- and post-intervention design. Setting: A 20-bed orthopaedic ward in a large teaching hospital in Ireland. Participants: Pharmacy, nursing and quality improvement staff. Intervention(s): A multifaceted intervention was designed which included changes in processes related to drug trolley organization and drug supply planning...
August 19, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28964688/administering-blood-products-before-selected-interventional-radiology-procedures-developing-applying-and-monitoring-a-standardized-protocol
#7
Nam S Hoang, Nishita Kothary, Seema Saharan, Jarrett Rosenberg, Andrew A Tran, Shaughnessy B Brown, David M Hovsepian
PURPOSE: To apply and monitor a single institution's adherence to internally established guidelines for the preoperative administration of platelets and/or fresh frozen plasma (FFP) before a specified subset of minimally invasive interventional radiology (IR) procedures. MATERIALS AND METHODS: Beginning in December 2008, we implemented a set of restrictive guidelines for preoperative platelet and/or FFP administration before IR procedures at a single academic hospital...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28948662/improving-performances-of-the-knee-replacement-surgery-process-by-applying-dmaic-principles
#8
Giovanni Improta, Giovanni Balato, Maria Romano, Alfonso Maria Ponsiglione, Eliana Raiola, Mario Alessandro Russo, Patrizia Cuccaro, Liberatina Carmela Santillo, Mario Cesarelli
RATIONALE, AIMS, AND OBJECTIVES: The work is a part of a project about the application of the Lean Six Sigma to improve health care processes. A previously published work regarding the hip replacement surgery has shown promising results. Here, we propose an application of the DMAIC (Define, Measure, Analyse, Improve, and Control) cycle to improve quality and reduce costs related to the prosthetic knee replacement surgery by decreasing patients' length of hospital stay (LOS) METHODS: The DMAIC cycle has been adopted to decrease the patients' LOS...
September 26, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28913487/perioperative-surgical-home-meeting-tomorrow-s-challenges
#9
REVIEW
Teodora O Nicolescu
New healthcare models pose a variety of changes for anesthesiologists, ranging from the need to improve quality and to cost containment: as such, the concept of Perioperative Surgical Home (PSH) has been developed. Modelled after the UK's Enhanced Recovery After Surgery (ERAS), PSH takes a step further by coordinating care starting from the time a surgical decision is made for the patient to as many as 30 days postoperatively, taking a logical evidenced-based approach to judicious preoperative testing. Perioperative surgical home also relies heavily on engineering imported strategies such as the use of Lean Six Sigma methodologies, and involves active participation of all stakeholders...
October 2016: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28828305/medical-and-scientific-writing-time-to-go-lean-and-mean
#10
REVIEW
Payal Bhardwaj, Sudip Sinha, Raj Kumar Yadav
The Lean Six Sigma methodology for process improvements and driving efficiency is old, but lean writing was adopted late by the pharmaceutical world in terms of size of the documents. The documents were lean earlier, and then became voluminous, and now we are about to complete a full circle in this regard, i.e., coming back to the lean documents again using e-formats and hyperlinking. Furthermore, writing has become more and more precise over time. The need for this lean and mean medical and scientific writing arose from voluminous research globally, both industry and academia which are abuzz with skyrocketing regulatory and scientific submission volumes...
July 2017: Perspectives in Clinical Research
https://www.readbyqxmd.com/read/28752089/the-use-of-operational-excellence-principles-in-a-university-hospital
#11
Eric R Edelman, Ankie E W Hamaekers, Wolfgang F Buhre, Godefridus G van Merode
The introduction of Operational Excellence in the Maastricht University Medical Center (MUMC+) has been the first of its kind and scale for a university hospital. The policy makers of the MUMC+ have combined different elements from various other business, management, and healthcare philosophies and frameworks into a unique mix. This paper summarizes the journey of developing this system and its most important aspects. Special attention is paid to the role of the operating rooms and the improvements that have taken place there, because of their central role in the working of the hospital...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28723845/lean-six-sigma-techniques-to-improve-ophthalmology-clinic-efficiency
#12
Thomas A Ciulla, Mohan V Tatikonda, Yehya A ElMaraghi, Rehan M Hussain, Amanda L Hill, Julie M Clary, Eyas Hattab
PURPOSE: Ophthalmologists serve an increasing volume of a growing elderly population undergoing increasingly complex outpatient medical care, including extensive diagnostic testing and treatment. The resulting prolonged patient visit times ("patient flow times") limit quality, patient and employee satisfaction, and represent waste. Lean Six Sigma process improvement was used in a vitreoretinal practice to decrease patient flow time, demonstrating that this approach can yield significant improvement in health care...
July 18, 2017: Retina
https://www.readbyqxmd.com/read/28679887/telehealth-and-the-re-design-of-emergency-medical-services
#13
Richard W Jones, George Despotou, Theodoros N Arvanitis
As patient numbers continue to rise Emergency Department's (ED's) are struggling to not only control patient wait times but also to maintain the quality of patient care. Improving patient flow through the ED has been a priority for many years with techniques such as Lean Six-Sigma being implemented specifically to help alleviate the problem. The Institute for Healthcare Improvement recently stated that the best opportunities to improving patient flow relate to the front-end of the ED, namely triage. This contribution examines the use of Telehealth initiatives at the front-end of the ED, specifically tele-consultation, to reduce patient loading, provide timelier healthcare (with improved patient outcomes) and reduce costs...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28674608/experiences-with-lean-six-sigma-as-improvement-strategy-to-reduce-parenteral-medication-administration-errors-and-associated-potential-risk-of-harm
#14
Afke van de Plas, Mariëlle Slikkerveer, Saskia Hoen, Rick Schrijnemakers, Johanna Driessen, Frank de Vries, Patricia van den Bemt
In this controlled before-after study the effect of improvements, derived from Lean Six Sigma strategy, on parenteral medication administration errors and the potential risk of harm was determined. During baseline measurement, on control versus intervention ward, at least one administration error occurred in 14 (74%) and 6 (46%) administrations with potential risk of harm in 6 (32%) and 1 (8%) administrations. Most administration errors with high potential risk of harm occurred in bolus injections: 8 (57%) versus 2 (67%) bolus injections were injected too fast with a potential risk of harm in 6 (43%) and 1 (33%) bolus injections on control and intervention ward...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28649480/the-role-of-organizational-culture-in-operating-room-turnaround-time
#15
David Ninan, Janet Zhu, Amanda Kore, Elizabeth Wasson, Tricia Fullerton, Barbara Ninan
This analysis looks at the application of a robust process improvement methodology to achieve a sustained organizational change. The implementation took place in a safety net hospital's operating suites that had a problem with relatively long, nonproductive turnover times between surgical procedures. Organizational leadership empowered stakeholders to use Lean and Six-Sigma tools to develop more efficient organizational processes. These processes were then implemented in a phased approach with careful attention to the organization's culture...
May 17, 2017: Curēus
https://www.readbyqxmd.com/read/28635297/medical-students-leading-quality-improvement-a-lean-six-sigma-approach-to-pain-management
#16
David Droullard, Samuel Porter, Anna Zuckerman, Daphne Monie, Judi Brendle, Henry Weil
No abstract text is available yet for this article.
June 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28614432/characteristics-of-nursing-professionals-and-the-practice-of-ecologically-sustainable-actions-in-the-medication-processes
#17
Patricia de Oliveira Furukawa, Isabel Cristina Kowal Olm Cunha, Mavilde da Luz Gonçalves Pedreira, Patricia Beryl Marck
Objectives: to verify the correlation between the characteristics of professionals and the practice of sustainable actions in the medication processes in an ICU, and to determine if interventions such as training and awareness can promote sustainable practices performed by nursing staff in the hospital. Methods: before-and-after design study using Lean Six Sigma methodology, applied in an intensive care unit. Nursing staff were observed regarding the practice of ecologically sustainable actions during medication processes (n = 324 cases for each group (pre and post-intervention)) through a data collection instrument...
June 8, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28614127/a-hospital-is-not-just-a-factory-but-a-complex-adaptive-system-implications-for-perioperative-care
#18
Aman Mahajan, Salim D Islam, Michael J Schwartz, Maxime Cannesson
Many methods used to improve hospital and perioperative services productivity and quality of care have assumed that the hospital is essentially a factory, and therefore, that industrial engineering and manufacturing-derived redesign approaches such as Six Sigma and Lean can be applied to hospitals and perioperative services just as they have been applied in factories. However, a hospital is not merely a factory but also a complex adaptive system (CAS). The hospital CAS has many subsystems, with perioperative care being an important one for which concepts of factory redesign are frequently advocated...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28552386/tools-and-methods-for-quality-improvement-and-patient-safety-in-perinatal-care
#19
Amy T Nathan, Heather C Kaplan
The quality of health care is now recognized to vary widely in all medical specialties, including perinatal medicine. A national focus on quality improvement (QI) and patient safety is prompting providers to change and improve the care given to patients. All QI and safety efforts require the use of an improvement model to manage the complex process of improving care. This article reviews the most common frameworks in use today, including the Model for Improvement, Six Sigma, and Lean. Specific tools such as affinity, key driver and fishbone diagrams, process maps and statistical process control, as well as checklists are reviewed, with examples from the perinatal literature to illustrate their use in perinatal QI efforts...
April 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28538055/high-reliability-principles-must-be-tied-to-value-based-outcomes
#20
Mitchell L Wasden
WellStar Health System and the Medical University of South Carolina (MUSC), highlighted in this issue's feature articles, are two organizations seeking to drive high reliability by educating leaders and incorporating high-reliability principles into their quality improvement (QI) efforts. The organizations have taken slightly different approaches to executing on high reliability, yet both are encouraged by the apparent success of high-reliability principles in other industries.The high-reliability framework is often applied to healthcare despite the limitations of comparing healthcare organizations to nuclear reactors, commercial airlines, and aircraft carriers...
July 2017: Frontiers of Health Services Management
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